Adolescent Injury Research Articles

Adolescent blunt solid organ injury: Differences in management strategies and outcomes between pediatric and adult trauma centers

BackgroundAdolescents with blunt solid organ injuries (BSOI) are cared for at both pediatric trauma centers (PTC) and adult trauma centers (ATC). Over the past decade, treatment strategies have shifted towards non-operative management with reported favorable outcomes. The aim of this study was to compare management strategies and outcomes between PTC and ATC. MethodsWe queried the 2016–2018 Trauma Quality Improvement Program (TQIP) datasets to identify adolescents between the ages of 16 and 19 with BSOI. Characteristics were stratified by center type (pediatric or adult) for comparative analyses. Separate logistic regressions were used to assess the association of hospital type, location of injury, age, gender, weight, Glascow Coma Score (GCS), Injury Severity Score (ISS), and intensive care unit (ICU) admissions for outcomes of interest. ResultsAmong the 3,011,310 patients enrolled in the 2016–2018 TQIP datasets, 106,892 (3.5%) had a BSOI ICD9/10 code. Of those, 9,193 (8.6%) were between 16 and 19 years of age and included in this analysis. Within this cohort, 6,073 (66.1%) were managed at an ATC and 3,120 (33.9%) were managed at a PTC. While statistically different, there were no clinically relevant differences for age, weight, and sex between groups. A significantly higher ISS and lower GCS score were observed among those admitted to ATC compared to PTC. ICU admissions were more frequent at ATC. Number of blood transfusions by 4 h after presentation were also higher among those admitted to an ATC. Despite a lower ISS and higher GCS at presentation, mortality was higher among those treated at a PTC with an odds ratio (95% confidence interval) of 2.42 (1.31–4.53). After excluding adolescents with a traumatic brain injury, a common cause of mortality among adolescent trauma patients, these differences in outcomes persisted. ConclusionsOur data suggest that adolescents with BSOI managed at a PTC are less likely to receive blood transfusions by 4 h of admission or be admitted to the ICU than those managed at an ATC. However, this more conservative approach may come at the expense of higher overall mortality. Further work is needed to understand these differences and determine if PTC need to be more aggressive in managing BSOI.

Comprehensive analysis of paediatric pelvic fracture urethral injury: a reconstructive centre experience.

To analyse our experience in pelvic fracture urethral injury (PFUI) in children and adolescents, with various anastomotic urethroplasties (AUs) used to accomplish tension-free anastomosis described and their surgical outcomes evaluated. From 2008 to 2019, 192 cases including both primary and redo PFUI, which comprised 181 boys and 11 girls aged ≤18 years. The results are presented separately according to gender. Moreover, the two populations were divided in two age-related sub-groups for sensitivity analyses: Group 1 (children) aged ≤11 years and Group 2 (adolescent) aged 12-≤18 years. The median (interquartile range [IQR]) age at presentation in our series was 14 (9-17) years for boys and 9 (6-10) years for girls. Primary vs redo cases were 85 (47%) vs 96 (53%) in boys and 10/11 vs one of 11 in girls. In the primary male cases (85), the bulbo-membranous junction was the commonest site of injury (63, 74.1%). In boys, transperineal AU (TPAU) was performed in 160 (88.4%) and transpubic urethroplasty (TPU) in 17 (9.4%). In girls, TPU was utilised in nine cases, where two received meatoplasty and vaginal episiotomy. In boys, the overall success rate for TPAU was 81.2% and in primary PFUI cases success for TPAU was 88.3%. Overall success for TPU was 64.7%. In girls, the success rate for TPU was 100%. In boys and girls, the success rates for various AUs utilised between the child and adolescent groups were comparable. The median (IQR) hospital stay was 3 (3-4) days for boys and girls. The median (IQR) follow-up duration was 25 (16-33) months and 20 (17-27) months for boys and girls, respectively. Secondary procedures were performed in 39 boys and one girl, which comprised laser optical internal urethrotomy in 26 (14.4%) boys and redo surgery in 13 (7.2%) boys and one (9.1%) girl. Of all patients, four of the 11 girls and 74 boys (38.5%) were lost to follow-up. Most paediatric PFUI can be addressed via a transperineal approach with reasonable long-term outcomes. In challenging cases salvage procedures utilising vascular-based flaps as a urethral substitute give satisfactory results. Even young children can be managed with a high success rate in expert hands and these injuries should be addressed by specialist reconstructive urologists.

Repetitive Mild Closed Head Injury in Adolescent Mice Is Associated with Impaired Proteostasis, Neuroinflammation, and Tauopathy.

Repetitive mild traumatic brain injury (mTBI) in children and adolescents leads to acute and chronic neurologic sequelae and is linked to later life neurodegenerative disease. However, the biological mechanisms connecting early life mTBI to neurodegeneration remain unknown. Using an adolescent mouse repetitive closed head injury model that induces progressive cognitive impairment in males and anxiety in females in the absence of overt histopathology, we examined transcriptional and translational changes in neurons isolated from sham and injured brain in the chronic phase after injury. At 14 months, single-nuclei RNA sequencing of cortical brain tissue identified disruption of genes associated with neuronal proteostasis and evidence for disrupted ligand-receptor signaling networks in injured mice. Western blot analysis of isolated neurons showed evidence of inflammasome activation and downstream IL-1β processing, as previously demonstrated in acute CNS injury models, and accumulation of misfolded, hyperphosphorylated tau, and changes in expression of proteins suggestive of impaired translation in males but not in females. At 6 months, injured IL-1 receptor 1 (IL-1R1) KO mice, which are protected from postinjury cognitive deficits, had decreased accumulation of pro-IL-1β and misfolded tau in cortex and cerebellum, suggesting that IL-1R1 is upstream of inflammasome priming (defined as increase in pro-IL-1β) and abnormal tau phosphorylation. Together, our findings provide evidence for neuronal inflammasome activation and impaired proteostasis as key mechanisms linking repetitive mTBI in adolescence to later life neurologic dysfunction and neurodegeneration.SIGNIFICANCE STATEMENT Repetitive mild closed head injury in adolescent male mice leads to impaired proteostasis, tau phosphorylation, and inflammasome activation in neurons later in adulthood through mechanisms involving IL-1 receptor 1. The data are the first to link repetitive mild traumatic brain injury in adolescence to neurodegeneration and suggest molecular targets and pathways to prevent neurologic sequelae in the chronic period after injuries.

Diagnostic Value of Magnetic Resonance Image Feature Analysis under Reconstruction Algorithm for Knee Epiphyseal Injury

To analyze the diagnostic value of magnetic resonance imaging (MRI) in epiphyseal injury of adolescent children, MRI images of 26 adolescent knee joint injuries were selected. The image display before and after reconstruction based on the compressed sensing theory (CS) algorithm was compared and analyzed, so did the signal-to-noise ratio of knee MRI reconstructed images under 2D random sampling and radial sampling at different sampling rates. The results showed that the sharpness, specificity, and accuracy of images reconstructed by the CS algorithm were significantly higher than those before reconstructionP<0.05. When the sampling rates were almost the same (20%, 40%, and 60%), the signal-to-noise ratio (SNR) of the reconstructed knee MRI images by random sampling was higher than that by radial sampling (about 9%, 6%, and 3% higher, respectively), that is, the information contained by random sampling was larger than that by radial sampling. It overcame the defects of undisplaced epiphyseal injuries in children and adolescents that cannot be found by plain X-ray films and can clearly and accurately diagnose epiphyseal injuries and fracture types that cannot be seen by plain X-ray films. To sum up, the MRI image reconstruction algorithm based on compressed sensing theory can effectively improve the diagnosis effect of knee epiphyseal injury.

Risk Factors for Ankle Fractures in Asian Adolescents Seen in a Pediatric Emergency Department.

Pediatric ankle injuries remain one of the most common presenting complaints to the pediatric emergency department (PED). In this study, we aimed to describe risk factors associated with simple ankle fractures and ankle fractures that require surgery, among adolescents presenting to the PED with ankle injuries. We analyzed a retrospective cohort study of adolescents 12 to 16 years old who presented to our PED with an acute ankle injury and received an ankle radiograph from November 1, 2016, to October 31, 2017. Demographic, anthropometric variables, physical examination findings including those of the Ottawa Ankle Rules were obtained. We recorded any surgical interventions required, as well as follow-up and to return to physical activity. Five hundred fifty-six cases of adolescent ankle injuries were reviewed, of which 109 adolescents had ankle fractures, whereas 19 had ankle fractures requiring surgery. Sports-related injuries remained the most common cause of ankle fractures. Age (adjusted odds ratio [aOR], 0.69; 95% confidence interval [CI], 0.56-0.83; P < 0.001), male sex (aOR, 2.12; 95% CI, 1.34-3.35; P < 0.001), clinical findings of tenderness over the lateral malleolus (aOR, 3.13; 95% CI, 1.74-5.64; P < 0.001) or medial malleolus (aOR, 3.55; 95% CI, 2.18-5.78; P < 0.001), and inability to walk (aOR, 3.09; 95% CI, 1.95-4.91; P < 0.001) were significant independent risk factors for ankle fractures.Patients with a weight more than 90th centile for age were at greater risk of ankle fractures requiring surgery (aOR, 2.64; 95% CI, 1.05-6.64; P = 0.04). We found that younger age, male sex, and clinical findings in the Ottawa Ankle Rules correlated well with predicting ankle fractures and are well suited for application in the Southeast Asian population. Weight greater than the 90th percentile for age was a significant risk factor for ankle fractures requiring surgery.

Novel Oppositional Defiant Disorder 12 Months After Traumatic Brain Injury in Children and Adolescents.

The investigators examined the factors predictive of novel oppositional defiant disorder in the 6-12 months following traumatic brain injury (TBI). Children ages 5-14 years old who experienced a TBI were recruited from consecutive admissions to five hospitals. Participants were evaluated soon after injury (baseline) for preinjury characteristics, including psychiatric disorders, adaptive function, family function, psychosocial adversity, family psychiatric history, socioeconomic status, and injury severity, to develop a biopsychosocial predictive model for development of novel oppositional defiant disorder. MRI analyses were conducted to examine potential brain lesions. Psychiatric outcome, including that of novel oppositional defiant disorder, was assessed 12 months after injury. Although 177 children were recruited for the study, 120 children without preinjury oppositional defiant disorder, conduct disorder, or disruptive behavior disorder not otherwise specified (DBD NOS) returned for the 12-month assessment. Of these 120 children, seven (5.8%) exhibited novel oppositional defiant disorder, and none developed conduct disorder or DBD NOS in the 6-12 months postinjury. Novel oppositional defiant disorder was significantly associated with lower socioeconomic status, higher psychosocial adversity, and lower preinjury adaptive functioning. These results demonstrate that novel oppositional defiant disorder following TBI selectively and negatively affects an identifiable group of children. Both proximal (preinjury adaptive function) and distal (socioeconomic status and psychosocial adversity) psychosocial variables significantly increase risk for this outcome.

Burden of Traumatic Brain Injuries in Children and Adolescents in Europe: Hospital Discharges, Deaths and Years of Life Lost.

Children and adolescents are at high risk of traumatic brain injuries (TBI). To identify those most at risk across Europe, a comprehensive epidemiological study on the burden of TBI is needed. Our aim was to estimate the burden of TBI in the pediatric and adolescent population of Europe by calculating rates of hospital-based incidence, death and years of life lost (YLL) due to TBI in 33 countries of Europe in 2014 (most recent available data). We conducted a cross-sectional observational, population-based study. All cases with TBI in the age range 0 to 19, registered in the causes of death databases or hospital discharge databases of 33 European countries were included. Crude and age-standardized rates of hospital discharges, deaths and YLLs due to TBI; and pooled estimates for all countries combined were calculated. TBI caused 2303 deaths (71% in boys), 154,282 YLLs (68% in boys) and 441,368 hospital discharges (61% in boys) in the population of 0–19 year-olds. We estimated pooled age-standardized rates of death (2.8, 95% CI: 2.4–3.3), YLLs (184.4, 95% CI: 151.6–217.2) and hospital discharges (344.6, 95% CI: 250.3–438.9) for the analyzed countries in 2014. The population of 15–19 year-olds had the highest rates of deaths and YLLs, and the population of 0–4 year-olds had the highest rate of hospital discharges. Detailed estimates of hospital discharge, death and YLL rates based on high-quality, standardized data may be used to develop health policies, aid decision-making and plan prevention.

Adolescent school injuries and classroom sex compositions in German secondary schools

BackgroundSchool injuries are an important adolescent health problem. Previous research suggests that relevant risk behaviors for school injuries, risk-taking and aggression, are highly susceptible to peer effects. Specifically, evidence suggests that the ratio of men and women in peer groups (sex ratio) affects individuals’ propensity for aggression and risk-taking. However, potential associations of classroom sex ratios with adolescent school injury risks have not been studied so far. The purpose of this paper is to investigate the association of classroom sex compositions with adolescent school injuries.MethodsWe investigate the association of classroom sex ratios with school injuries in a longitudinal survey dataset containing 13,131 observations from 9,204 adolescent students (ages 13-16) from secondary schools in Germany. The data also allow us to identify injuries due to aggressive behavior and analyze these injuries in detail. We use multilevel logistic regression models to analyze risks of both overall and aggression-related school injuries.ResultsAdolescent students’ risk for school injuries is significantly and positively associated with male-skewed classroom sex ratios (OR = 1.012, p=0.012). Specifically, the risk of sustaining a school injury increases by 33.5 percent when moving from the 10th to the 90th classroom sex ratio percentile. Moreover, we find an even stronger positive association between male-dominated classrooms and aggression-related injury risks (OR = 1.022, p=0.010). Compared to classroom sex ratios at the 10th percentile, the risk of an aggression-related injury is 78 percent higher in classrooms with a sex ratio at the 90th percentile. Finally, we find that both boys’ and girls’ injury risks equally increase with a higher proportion of male students in their classroom.ConclusionsOur findings indicate that sex composition of classrooms is an important contextual factor for adolescent school injuries, in particular school injuries resulting from aggression. These findings illustrate the need to integrate a contextual perspective on school injuries among adolescent students both into research and into intervention planning.

Modern approaches to the diagnostics and treatment of the consequences of traumatic brain injury in children and adolescents

The article is devoted to an important problem of modern pediatric neurology and rehabilitation, - the issues of diagnosis and comprehensive restorative treatment of the consequences of traumatic brain injury (TBI) in children and adolescents. It is known that TBI is characterized by a high frequency of disability, while asthenic, vegetative, cognitive, emotional, motor and postural disorders are leading in the clinical picture. It is shown that the factors influencing the severity of the consequences of TBI in children are not only the severity of the injury itself, but also the age at which the injury occurred, as well as the localization of the lesion. The article describes modern methods of complex diagnosis and rehabilitation of the consequences of TBI in children, as well as pathogenetically justified approaches to drug therapy, while showing the high effectiveness of the drug choline alfoscerate (Cereton) in restoring cognitive functions and improving the clinical condition in children with the consequences of TBI, according to the results of a double-blind placebo-controlled multicenter randomized trial.

Longitudinal assessment of hemodynamic alterations after mild traumatic brain injury in adolescents: Selected case study review

Alterations in the neurovasculature after traumatic brain injury (TBI) represents a significant sequelae. However, despite theoretical and empirical evidence supporting the near-ubiquity of vascular injury, its pathophysiology remains elusive. Although this has been shown for all grades of TBI, the vascular changes after injuries with the broad mild traumatic brain injuries (mTBI) classification, remain particularly difficult to describe. Our group has previously demonstrated hemodynamic alterations in mTBI by utilizing transcranial Doppler ultrasound and cerebrovascular reactivity in a cross-sectional study. That work identified a phasic progression of deviations over varying days post-injury. These phases were then characterized by a set of inverse models that provided a hypothetical process of hemodynamic dysfunction after mTBI. This model set provides a framework with the potential for guiding clinical treatment over the course of recovery. However, it is still unclear if individual patients will progress through the phases of dysfunction similar to that found at the population level. The work presented here explores six individual patients with high-density data collected during their post-injury recovery. Breath-hold index (BHI) was found to be the most robust feature related to mTBI longitudinally. All six subjects exhibited BHI recovery curves that followed the population model's progression. The changes in pulsatile features lacked the universality of BHI, but were present in subjects with higher self-reported symptom scores and longer periods of recovery. This work suggests neurovascular dysfunction after an mTBI may be a robust phenomenon. Additionally, the capabilities of TCD in capturing these changes highlights its potential for aiding clinicians in monitoring patient's recovery post mTBI.

The risk factors and pattern of traumatic dental injuries in 10-12-year olds in Kano, Nigeria.

Traumatic dental injuries (TDIs) rank among the most common conditions in children and adolescents. Nigerian dental trauma data are largely based on studies that were conducted in the southern parts of Nigeria. This study was designed to identify the risk factors and the pattern of TDIs among school-age children in northern Nigeria. The objective of the study was to identify the risk factors for and to determine the pattern of dental injuries among 10-12-year-old males in Kano, northern Nigeria. Six hundred and ninety-six 10-12-year olds were selected through a multistage sampling of school children, street children and rehabilitated children in Kano and examined for TDIs using the WHO protocols. Data analysis was carried out using SPSS version 20. Statistical significance was considered when P < 0.05. Six hundred and ninety-four 10-12-year olds participated in the study; The prevalence of TDIs was 6.6%. Being a street-child was associated with 30% higher risk for dental injuries (adjusted odds ratio [aOR] = 1.3; 95% confidence interval [CI] = 0.60 - 3.1; P = 0.48), whereas living as a rehabilitated street child (aOR = 0.41; 95% CI = 0.19 - 0.88; P = 0.02) and older age were associated with a reduced risk (aOR = 0.63; 95% CI = 0.39 - 1.01; P = 0.06) to injuries. The most common type of trauma was enamel-dentine injuries or Ellis II, and the most common cause was falls. Street children and low-age groups had more single-tooth injuries (85.7% and 85.0%, respectively). The commonly injured teeth were the maxillary right and left central incisors. Living on the street and young age were associated with the likelihood for injuries in male adolescents in Kano. The maxillary central incisors were the commonly affected teeth.

Unintentional injuries of children and adolescents treated in emergency medical services: A cross-sectional study

Background/Aim: Unintentional injuries among children and adolescents have become a common issue in public healthcare. The study objective was to analyse the characteristics and identify predictors associated with unintentional injuries in children and adolescents treated in emergency medical services (EMS) in the Republic of Srpska, Bosnia and Herzegovina. Methods: A cross-section study with retrospective analysis of WebMedic e-database from 14 EMS, in the period between January 2018 and December 2020 was conducted. Research included patients with unintentional injuries, aged ≤ 19 years, of both sexes. For comparison between groups, Chi-squared and multivariate logistic regression were used in risk factor analysis. Results: A total of 1,856 cases were identified, most injuries resulted from falls (46.7 %) and traffic injuries (26.9 %). Boys were significantly more affected by injuries than girls (p &lt; 0.001). Falls were the major cause for reporting to EMS among age groups of children (0-9 years) and adolescents (10-14 years), whereas injuries in traffic were dominant in adolescents aged 15 to 19. The most common injuries were head injuries (35.7 %). Risk factors of unintentional injuries were age (p &lt; 0.001), sex (p = 0.046), weekday (p = 0.016), winter (p = 0.014), body region (head, abdomen, lower and upper limbs (p &lt; 0.001), thorax (p = 0.009)). Conclusions: There were significant differences in characteristics of unintentional injuries according to age and sex. Chances for occurrence of unintentional injuries among children increased with their age, especially for boys. These differences might indicate areas where preventive measures should be undertaken.

Social Indicators with Serious Injury and School Bullying Victimization in Vulnerable Adolescents Aged 12-15: Data from the Global School-Based Student Survey

Social Indicators with Serious Injury and School Bullying Victimization in Vulnerable Adolescents Aged 12-15: Data from the Global School-Based Student Survey

Phenomenology of adolescent parenting injuries in cyberspace

Background and Aim: Today's world has accelerated to digitize, and the number of users is increasing every moment. Cyberspace, along with its benefits, also causes damage. The purpose of the present study was to formulate and validate adolescent adolescent education programs in cyberspace to help help adolescents and community mental health and reduce cyberspace damage. Methods: The present study was a qualitative type of contextual theory, and the research data was obtained using semi -structured and deep interviews with parents who had the criteria for entry into the Delphi method. Open, central and theoretical codes were then extracted, and based on them, a conceptual model was designed in the field of damages and strategies caused by cyberspace. Results: That indicates that parenting styles in different social situations, including virtual situations, have changed, the findings showed that parents are out of power because of their special injuries Conclusion: The results of the study indicate that if parents and adolescents receive the necessary and timely awareness, many of the damage and conflicts between them as well as the damages caused by cyberspace for adolescents and their families will be prevented

Adolescent proximal tibial epiphyseal injury: two cases report

Adolescent proximal tibial epiphyseal injury: two cases report

Alcohol is not associated with increased mortality in adolescent traumatic brain injury patients

PurposeCompared to adults, there is a paucity of data regarding the association of a positive alcohol screen (PAS) and outcomes in adolescent patients with traumatic brain injury (TBI). We hypothesize adolescent TBI patients with a PAS on admission to have increased mortality compared to patients with a negative alcohol screen.MethodsThe 2017 Trauma Quality Improvement Program database was queried for patients aged 13–17 years presenting with a TBI and serum alcohol screen. Patients with missing information regarding midline shift on imaging and Glasgow Coma Scale (GCS) score were excluded. A multivariable logistic regression analysis for mortality was performed.ResultsFrom 2553 adolescent TBI patients with an alcohol screen, 220 (8.6%) had a PAS. Median injury severity scores and rates of penetrating trauma (all p > 0.05) were similar between alcohol positive and negative patients. Patients with a PAS had a similar mortality rate (13.2% vs. 12.1%, p = 0.64) compared to patients with a negative screen. Multivariate logistic regression controlling for risk factors associated with mortality revealed a PAS to confer a similar risk of mortality compared to alcohol negative patients (p = 0.40).ConclusionAdolescent TBI patients with a PAS had similar associated risk of mortality compared to patients with a negative alcohol screen.

Predictors of health-related quality of life following injury in childhood and adolescence: a pooled analysis

BackgroundInjury is a leading contributor to the global disease burden in children and places children at risk for adverse and lasting impacts on their health-related quality of life (HRQoL) and...

The relationship between adolescent injuries and risk factors

Purpose of the study. The aim of our study was to examine the relationship between existing risk factors and adolescent trauma&#x0D; Materials and methods. In order to establish a link between adolescent injuries and risk factors, we conducted a sociological study among injured adolescents who received medical care at the Zaporozhye Regional Clinical Children’s Hospital and adolescents enrolled in vocational schools. (The questionnaire was approved by the Methodical Council. Minutes № 12 of 24.12.19). The questionnaire included 23 questions aimed at establishing demographic data and identifying personal, family and social risk factors. Personal risk factors included; smoking, alcohol use, drug and psychotropic drug use.&#x0D; Family risk factors include risk factors such as alcohol abuse in the family, raising their voices against each other, and cases of physical violence against adolescents. Social risk factors include: not a full family, living in a dormitory, having an income per family member less than the subsistence level.&#x0D; Statistical processing of the obtained materials was performed on a personal computer using a package of licensed applications EXCEL-2003 and STATISTICA. Levels of reliability: (p &lt; 0,05).&#x0D; Research results and their discussion. The first group of the study (hereinafter group A) included 168 respondents aged 15 to 17 years. The second group of the study (hereinafter group B) included 283 respondents aged 15–17 years.&#x0D; In group A it was found that among the respondents prevailed boys 98 people (58,33%), girls 70 (41,67%). Residents of the city 108 people (64,29%), residents of the village 60 people (35,71%). 146 respondents (86,90%) lived with their families, and 22 (13,10%) lived in dormitories.&#x0D; They had a complete family of 118 (70,24%), not a complete family of 50 (29,7%). It was found that 20 respondents (11,90%) had an income per family member less than the subsistence level.&#x0D; In the second group (group B) among 283 respondents – 150 (53,0%) males and 133 (47%) females.&#x0D; There are 173 inhabitants of the city (61,13%), 110 inhabitants of the village (38,86%). 244 people (86,21%) lived with their families, 39 (13,10%) lived in dormitories, and 184 people (65,01%) were found to live in a complete family.&#x0D; As we can see, the groups for studying the connection between adolescent injuries and the risk factors that could lead to injuries were compared according to age (adolescents aged 15–17), in percentage terms close to gender, city of residence, marital status.&#x0D; Given that we are studying a group of adolescents who have already been injured, the method of research is case-control.&#x0D; A study examining the relationship between personal, family, and social risk factors and adolescent trauma yielded: strong reliable correlation in the cohort of respondents who drink alcohol (x2 = 6,2; p = 0,01); strong correlation with a significant correlation (p = 0,001) between such family risk factors as alcohol consumption in the family; (x2 = 65,5; p = 0,001), raising the voice against each other (x2 = 36,9; p = 0,001), physical violence (x2 = 6,7; p = 0,01).&#x0D; Conclusions. Given the results obtained, injury prevention measures should be built on a crosssectoral basis, comprehensively, while addressing issues of social, family and personal direction among adolescents and parents.

Overview on Causes, Diagnosis and Management of Knee Injuries in Children and Adolescents: Review Article

This review aimed to summarize the updates in the causes, diagnosis and management of knee injuries in children and adolescents. Knee injuries are common and are often the result of multiple forces: varus, valgus, hyperextension, hyperflexion, internal rotation, external rotation, anterior or posterior translation, and axial loading. Certain combinations of force are known to cause specific patterns of injury. A knee injury can affect any ligaments, tendons, or fluid-filled sacs (bursae) that surround the knee joint, as well fas the bones, cartilage, and ligaments that make up the joint itself. ACL injuries are one of the most common types of knee injuries, including a torn meniscus that is common in sports that require jumping jacks, patellar fractures, and knee bruises. Magnetic resonance imaging (MRI) is often used to more fully evaluate knee injuries. Radiologists can accurately identify individual lesions and combinations of lesions. Surgical and non-surgical treatments are performed depending on the case.

Retrospective review of intervention for traumatic blunt spleen injuries in adolescents by trauma center type

BackgroundManagement guidelines for pediatric blunt spleen injuries (BSI) include adolescent patients but few studies have compared current management of adolescents with respect to other age groups by center type. MethodsA retrospective review of 2017–2018 National Trauma Quality Improvement (TQIP) data of children (6–12), adolescents (13–17) and young adults (18–24) with BSI presenting to an adult, pediatric only, or adult/pediatric trauma center, comparing the rate of splenic intervention for adolescents by trauma center was performed. ResultsChildren had lower odds of spleen intervention than adolescents at both adult (OR 0.61 95%CI 0.39, 0.95) and adult/pediatric (OR 0.55 95%CI 0.35, 0.87) centers but did not differ at pediatric centers (OR 0.94 95%CI 0.39, 2.2) (n = 10,494). Adolescents adjusted odds of intervention was equal to adults at adult trauma centers (OR 1.2 95%CI 0.95, 1.4). ConclusionAdolescents are more likely to undergo interventions for BSI as compared to children at both adult and adult/pediatric trauma centers.